An RPE detachment can be hemorrhagic in the presence of neovascular membranes. Retinal hemorrhages often are seen under the RPE. Detachment of the RPE forms a steep angle to the choriocapillaris, and the accumulated blood cells block penetration of the light rays from OCT in the area of the detachment, so the penetration is minimal and forms a shadow that hides the choriocapillaris and other subsequent layers (Figure 5).

 

 

During development of exudative AMD, OCT shows serous detachments of the RPE as optically clear areas between the RPE and the choriocapillaris (Figure 6). The detached pigment epithelium forms a steep angle with the underlying choriocapillaris, which may be initially clear and then contains cells and becomes blurred. A detachment also can be single, multiple, dome-shaped, or bilobed.^6,8,24

 

 

Active choroidal neovascular membranes cause edema and small serous detachments of the neurosensory retina. The membranes also can occur frequently in cases of pigment epithelial tears (Figure 7).